Primecare PSC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26429 Issued in KY

Legal business name

PRIMECARE PSC

Practice address

2413 Ring Rd Ste 110
Elizabethtown, KY 42701-5924

Phone

(270) 765-4535

Fax

(270) 763-1901

NPI assigned

Nov 28, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David J. Zoeller, MDNPI 1194708776

Title

Physician/Owner

Phone

(270) 765-4535

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David J. Zoeller, MD

  • Family Medicine Physician
  • Elizabethtown, KY
  • NPI 1194708776
  Medicare reassignment Care Compare group NPD Authorized official
• Rachel Jordan Archibald, DNP

  • Family Nurse Practitioner
  • Elizabethtown, KY
  • NPI 1063259232
  Medicare reassignment Care Compare group NPD
• Lindsey M. Monin

  • Nurse Practitioner
  • Elizabethtown, KY
  • NPI 1790132371
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1023091600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 RING RD STE 110",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427015924",
            "telephone_number": "270-765-4535",
            "fax_number": "270-763-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2413 RING RD STE 110",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427015924",
            "telephone_number": "270-765-4535",
            "fax_number": "270-763-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "ZOELLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "270-765-4535",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "26429",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507510",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78904083",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65922940",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100060440",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Priddy, CRNA
• Sarah Priddy, PHARMD
• Ronnie Pridemore, M.D.
• Primary Care @ Home, LLC
• Primary Injury Care
• Benjamin L Proctor, M.D.
• Robyn Proctor, LPCA
• Sarah Alanson Proctor, D.M.D
• Skylynne Proffitt, APSS
• Jane Prouty, LMFT, LPCC, CADC

• Family Medicine Physician in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.